Healthcare Provider Details

I. General information

NPI: 1154798643
Provider Name (Legal Business Name): MR. JONATHAN EMANUEL SESMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 S 2ND ST
BROOKLYN NY
11211-4305
US

IV. Provider business mailing address

2361 31ST ST
ASTORIA NY
11105-2809
US

V. Phone/Fax

Practice location:
  • Phone: 718-384-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number105905
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: